Indiana State Department of Health

MDS Overview

The Minimum Data Set (MDS) 3.0 system is one part of the QIES Assessment Submission and Processing (ASAP) system. MDS 3.0 provides computerized storage, access, and analysis of the assessment data for residents in nursing homes and patients in swing bed (SB) hospitals across the United States, Puerto Rico, Virgin Islands, and Guam. MDS 3.0 creates a standard, nationwide system for nursing homes and SB hospitals to submit MDS assessment data to a national repository.

Manuals, Guides and Technical Resources

RAI Manual -The purpose of this manual is to offer clear guidance about how to use the Resident Assessment Instrument (RAI) correctly and effectively to help provide appropriate care. Providing care to residents with post-hospital and long-term care needs is complex and challenging work. Clinical competence, observational, interviewing and critical thinking skills, and assessment expertise from all disciplines are required to develop individualized care plans. The RAI helps nursing home staff gathers definitive information on a resident’s strengths and needs, which must be addressed in an individualized care plan. It also assists staff with evaluating goal achievement and revising care plans accordingly by enabling the nursing home to track changes in the resident’s status. As the process of problem identification is integrated with sound clinical interventions, the care plan becomes each resident’s unique path toward achieving or maintaining his or her highest practical level of well-being.

MDS 3.0 User’s Guide -This guide provides information and instructions pertaining to the QIES ASAP MDS 3.0 system to Long Term Care (LTC) facility and Swing Bed (SB) hospital users who are required to submit assessment data regarding their residents and patients. It is intended to be used as a reference and learning tool for the MDS 3.0 system.

RUG-III Version 5.20 Grouper Files and Case Mix

RUG-III version 5.20 Grouper files –The RUG-III Version 5.20 Grouper package includes the 53-group RUG-III model that will be used for billing Medicare Part A SNF PPS days of service starting January 1, 2006. This package provides general information, software, and technical documentation for RUG-III Version 5.20.

Case Mix Prospective Payments for SNF’s Balanced Budget Act of 1997 –Section 4432(a) of the Balanced Budget Act (BBA) of 1997 modified how payment is made for Medicare skilled nursing facility (SNF) services. Effective with cost reporting periods beginning on or after July 1, 1998, SNFs are no longer paid on a reasonable cost basis or through low volume prospectively determined rates, but rather on the basis of a prospective payment system (PPS). The PPS payment rates are adjusted for case mix and geographic variation in wages and cover all costs of furnishing covered SNF services (routine, ancillary, and capital-related costs).

Memorandums, Survey & Certification Letters

Nursing Home Compare & Five Star Report

Nursing Home Compare & Five Star Report -The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions.

Regulations

Guidance for Laws and Regulations for Nursing Homes –Survey protocols and Interpretive Guidelines are established to provide guidance to personnel conducting surveys. They serve to clarify and/or explain the intent of the regulations and all surveyors are required to use them in assessing compliance with Federal requirements.